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Is a Low-Carb Diet Ruining Your Health?

by Laura Beth Schoenfeld, RD

Last updated on

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Carbohydrates, and the role they play in a healthy diet, are one of the most hotly contested nutritional debates in the world, both in conventional and ancestral health circles.

One one side, you’ve got folks who say that carbohydrates are nonessential and increase your risk for diseases such as diabetes, cancer, and neurological disorders. On the other side, some say that carbohydrates are crucial for good health and should make up the majority of your calories.

It’s no wonder I have so many clients who come to me completely confused about carbs and whether or not they should eat more or less of them.

While some people do incredibly well following a low carb Paleo diet, there are many people who crash and burn on this type of dietary plan. So, how can you tell if you’re the type of person who shouldn’t be eating a low carb diet, and how do you figure out how many carbs you should be eating? I plan to teach you just that in this article.

Is your low-carb diet doing you more harm than good? Find out how many carbs YOU should be eating.

Pregnancy

I recently discussed the role of carbohydrates during pregnancy in an episode of The Ancestral RDs Podcast. The most important reason why women need adequate carbohydrates during pregnancy is to ensure adequate fetal brain development and growth. Another reason is because a high protein diet can be dangerous during pregnancy, and when you cut out carbohydrate as a major macronutrient, you usually can’t help but increase protein as a percentage of calories. Protein intake greater than 25% of calories during pregnancy may lead to decreased mass at birth and increased perinatal morbidity and mortality for the baby.

The Institute of Medicine recommends a minimum of 175 grams of carbohydrates per day during pregnancy, which is 29% of calories on a 2400 calorie diet. Paul Jaminet advises pregnant mothers to restrict protein to about 15% of calories and to obtain 30% of calories as carbohydrates. Chris recommends a moderate carb approach for most pregnant women (except those with any type of diabetes) in his book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014).

Like these other experts, I generally recommend 30% of calories from carbohydrates for my pregnant clients, and also for those who are struggling with fertility. Unless you have diabetes or a serious neurological condition that requires carbohydrate restriction, it’s not worth the risk playing around with a low carb diet when you’re pregnant, and these diets aren’t conducive to fertility for many women either. (If you’re interested in more reasons why carbohydrates can affect fertility, read this great post by Stefani Ruper.)

Athletes

If you’re a professional or recreational athlete who trains hard 4, 5, or even 6 days per week (I hope you’re not doing 7 days per week!) and trying to maintain this level of activity on a low carb diet, you may be doing more harm than good to your health and fitness.

While there are athletes who thrive on a well-planned low carb approach (LeBron James most recently!), there are many others who do not. Each athlete is completely unique in their ability to perform well on a low carb diet, and there’s nothing wrong with testing out the diet to see how it affects your athletic ability.

But if you’ve been trying a low carb diet for months now and your workouts are suffering, your weight isn’t budging (or maybe you’ve even gained weight!), and your recovery time is increasing, you’re probably not the type of person who can handle a low carb diet combined with regular intense physical activity.

I’ve had many clients come to me on a low carb diet who, after switching to a more moderate carb approach, found that their energy and endurance significantly increased, and they were able to make quicker strength gains than before. Many also were able to shed some of the stubborn body fat that they’d been retaining despite eating a low carb diet and training hard, which was a result they didn’t expect!

For my athletic clients, I usually recommend a minimum of 20% of calories from carbohydrate, and depending on the person’s health goals, training schedule, and current issues, I may actually recommend more like 40-50% of calories from carbs.

Again, each athlete is an individual and what works for one person, or even a thousand people, may not work for you. So don’t be afraid to experiment and pay attention to how your diet makes you look, feel, and perform! And don’t hesitate to get help if you need it!

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Hypothyroidism and HPA Axis Dysregulation (Adrenal Fatigue)

Hypothyroidism is one of the most commonly cited medical reasons for needing to eat a moderate carb diet. The main reason why carbs affect thyroid function so directly is because insulin is needed for the conversion of the inactive T4 hormone into the active T3 hormone, and insulin is generally quite low on very low carbohydrate diets.

So if you’ve suddenly started developing hypothyroid symptoms on your low carb diet, it’s a pretty good sign that you’d be better off upping the carbs (and getting your thyroid tested if you haven’t already!) For more about how low carb dieting affects your thyroid, listen to this great interview with Chris by Jimmy Moore.

HPA axis dysregulation, also known as adrenal fatigue, is another condition where a moderate carb intake is important for general health. Kelsey and I talked about adrenal fatigue on our first Ask the RD podcast, so listen to it if you’re unfamiliar with this condition. The main hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to increase on a low carb diet. This means that a low carb diet is a potential adrenal stressor in susceptible individuals. Combine that with a stressful job, inadequate sleep, and overexercise, and you’ve got yourself a recipe for adrenal burnout.

So if you have adrenal fatigue, or if your current lifestyle is already high stress in a few different areas, you may want to increase your carb intake until you can get those additional stressors under control, as you may drive yourself into adrenal fatigue by having a chronically elevated cortisol output. Lara Briden has written a great article on the benefits of whole food carbohydrates in lowering cortisol and raising GABA, a calming hormone that is often low in adrenal fatigue patients.

If you’re experiencing symptoms of hypothyroidism or adrenal fatigue, you may be worsening them with a well-intentioned low carb Paleo diet. I recommend working with someone to help you figure out if your diet is indeed making these symptoms worse, and how to change what you eat to better support your thyroid and adrenal health.

Gut Health

One of the less discussed downsides of a very low carbohydrate diet over the long run is the potential for alteration of the gut flora. Chris recently covered this issue in a podcast with Jeff Leach, where they discussed evidence that a very low carb diet can lead to gut dysbiosis and a reduction in the diversity of the gut flora. A lot of the information on this topic is new and not fully understood, but it’s reasonable to believe that when you avoid carbs, you’re also avoiding important prebiotics (i.e. food for your gut flora) like soluble fiber and resistant starch.

These prebiotics are essential for promoting the growth of beneficial gut flora. Without them, your beneficial flora can’t produce as much gut-healing substances like butyrate and other short chain fatty acids, and your microbiome composition may even shift in an undesirable direction. And as Chris would say, you’re only as healthy as your gut is: an unhealthy gut contributes to everything from obesity and diabetes, to digestive illness, to autoimmune disease, to skin disorders.

Those who are doing very low carbohydrate diets, and who simply can’t increase their starch intake for whatever reason, should use prebiotic supplements such as resistant starch-rich unmodified potato starch or FOS powder. However, these products must be incorporated slowly into your supplement regimen, as you can experience severe gas and bloating if too many prebiotics are taken all at once, or if there is existing gut dysbiosis or bacterial overgrowth. In this case, it would be wise to work with someone who can help you get the prebiotics you need while on a very low carbohydrate or ketogenic diet to protect the health of your gut microbiota.

How Many Carbs Do I Need?

To determine how many carbs my clients need to eat in a day to reach their health goals, first I decide what percentage of calories from carbs they’d possibly do best with. As an example from above, a woman struggling with fertility issues may benefit from a carb intake around 30% of calories. I then determine her caloric needs using a calculator like this one. If we determine that her daily needs are roughly 2000 calories per day, 30% of calories from carbs is 600 calories. As there are 4 calories in a gram of carbohydrate, this works out to be 150 grams of carbs per day.

Usually I give my clients a target range to hit depending on their activity levels, and we use these targets to re-evaluate their food diaries and see if they’re hitting their goals. Most of my clients are surprised to learn how much carb-rich Paleo foods they have to eat to get up to 150-200 grams per day! But once they start making a real effort to hit those targets, the health benefits are immediate.

These benefits include weight loss, elevated mood, skin improvements, increased energy, normal menstrual function, more satisfying sleep, and more. It’s so exciting to see what a couple of starchy tubers and pieces of fruit can do for a person’s health when they simply need to eat more carbs!

Final Thoughts

The purpose of this article was not to bash low carb diets. I truly believe that there are many people out there who get amazing health results from a low carb plan, and there are dozens of health conditions that benefit from a very low carb or ketogenic diet, especially severe neurological conditions. Paul Jaminet has written some great posts explaining when a ketogenic diet may be useful and necessary, so I strongly suggest reading those posts if you’re still on the fence about where you stand with carbohydrates and your health needs.

My hope is that by reading this article, you’ll be able to understand the many factors that play into how a person handles a low carbohydrate diet, and whether or not their health will improve on such a plan. Everyone is different in their ability to thrive on a low carbohydrate diet. If you’ve found yourself identifying with any of the issues I’ve written about in this post, you may be in need of a macronutrient adjustment in your diet.

Helping people optimize their carb intake is a challenge I truly enjoy. As a dietitian, I love to help people evaluate their diet to determine if they’re meeting their health needs with the food they’re eating. If you think you could benefit from a Paleo diet makeover, I’d love to chat with you about where you’re at and where you want to go with your health.

Your carb intake shouldn’t be the major factor that’s preventing you from reaching your health goals. I hope you use the information I’ve shared today to evaluate your own nutritional needs and make the changes that make sense to you.

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Laura Beth Schoenfeld, RD
Laura Beth Schoenfeld, RD

Laura Schoenfeld, MPH, RD, is a licensed registered dietitian and women’s health expert trained in Functional Medical nutrition therapy. She assisted in the creation of educational materials for both the ADAPT practitioner and health coach training programs.

Her passion is empowering women to nourish their bodies, develop true strength, and ultimately use their improved health to pursue their purpose. Laura guides her clients in identifying and implementing diet and lifestyle changes that allow them to live a healthy, fit, symptom-free life without being consumed by thoughts of food and exercise. She draws from a variety of sources to form her philosophy on nutrition, including ancestral diets, principles of biochemistry, current research, and clinical experience. Her areas of expertise include women’s hormones and fertility, gut health, autoimmune disease, athletic performance, stress management, skin health, and weight loss. Recognizing that health goes far beyond just diet and exercise, Laura teaches her clients how to focus on and implement life-changing mental and spiritual health habits as well, including changing their thoughts and beliefs to ones that drive health-supporting decision-making around food, fitness, and life in general.

Her greatest mission is to help health-conscious women realize that, while their health is priceless, they are so much more than a body. When she’s not educating and serving her coaching clients and community, Laura loves traveling with her husband, Sundays with her church family, hikes with her dog, beach trips, live music, and strength training.

Professional website: lauraschoenfeldrd.com

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417 Comments

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  1. I in no way know what the ones who have struggled with low carb and their health ate for protein while they were low carb, but it has been my experience with people I work with, mostly women, that they have usually fallen for the HIGH FAT camp and their protein is way too low. High fat, low protein is essentially starvation and starving (hypo caloric) seems to be what is behind thyroid-adrenal, keto related problems. We see so many people coming from too low of protein with energy problems, hair falling out, depression, etc.

    I once was in this camp, lost hair, my energy and lots of lean body mass! For the past year I have been keto with optimal protein and am feeling fantastic! I am losing again (thanks to some IF and keto), my insulin numbers are down and ALL of my blood work is fabulous and has much improved in one year.

    Again, I know there are many factors to the struggles with low carb diets and no one diet is perfect for everyone, but I think it important to look at the other macros as well. =

    This is a great article by Steve Phinney, a well known keto expert.http://www.ketothrive.com/nutrition/does-your-thyroid-need-dietary-carbs/

  2. WHy is every keto dieter suddenly Gluten free? Keto was the easiest diet ever. Now suddenly all this nonsense is being added to the fray. THIS is when something good gets a the tinges of cult and BS. It is no longer that pure low carb diet – NO, now it’s a whole wad of supplements and …sorry but if you’re low-carbing WHY are you even on gluten free anything.Starting to be really irritated with this new look diet and stop calling it BAnting since Banting promoted rusks and sherry in the afternoons. We can never just get something pure and simple. SOMEONE has to come and fiddle with it.

    • Maguerita,

      “Gluten-free” just means you don’t eat gluten. It doesn’t mean you eat gluten-free processed foods.

      • Yes! We so need to come up with a term that implies “free of gluten” without the long explanation…………FOG doesn’t cut it but I may have to to start using it lol.

  3. I’ve only been doing Atkins for a week now (<20g Carbs/day), so am obviously NOT an expert, but just wanted to share an observation.

    I've read a lot of the posts here and all of them reference only their carb intake. That's just part of the picture. What is your fat and protein intake? Doesn't this make a difference?

    Again, NOT an expert just asking.

    • It depends on the person.

      If you’re upping carbs, the person order I would drop with is;
      1) drop a little protein and carbs
      2) drop some fat
      If you’re deeper in, you can probably drop protein and keep the fat.
      Whatever works for you.

  4. Once dreaded for having high levels of cholesterol, whole eggs are regaining their relevance as a food for weight loss. New studies now indicate they do not affect blood cholesterol adversely and neither cause heart attacks. Whole eggs offer an easy diet to lose weight. They are high in healthy fats and protein and can make aperson feel full while having taken just low amounts of calories for Weight Loss Diet. Eggs are known to have high density of nutrients and can supply all the required content of nutrition for someone taking a calorie-restricted diet. Nearly all the necessary nutrients are contained in yolks.

  5. Flat out wrong across the board – low carbs only induce hypothyroidism if you are missing the following nutrients from your diet. Selenium, Iodine, Iron, Magnesium, Zinc, and DHA.
    . Poorly educated and a very understanding of neural biochem.

    • Hi Asad, what do you mean by it can induce hypothyroidism ? I have been eating LCHF now for 2 years (see my post below)
      I have leg jitters that magnesium supplements are making worse and giving me a terrible headache. I am not losing weight anymore even though I eat below 20 gm carbs a day and have done for a long time now.Somedays I feel great and others I feel terrible but cannot up my carbs as I bloat up like a balloon. I know I am lacking in something or have done something to my body through eating this way but do not know what to do about it. My legs are twitching terribly as I am writing this and I have already taken 2 tabs of 300 mg magnesium today which nearly sent me off the hyper scale and gave me a terrible headache. Any suggestions ??

      • went to the doctors about 3 weeks ago and had blood tests for everything as told him I ate LCHF for nearly 2 years. He prescribed me Quinine Sulphate tablets as all the blood tests came back negative. So far been cramp free for 3 weeks now and still eating LCHF. You can only take these for a month then you have to have a break, so I will see what happens when I stop taking them. Back to my old energetic self now and still 8.7 stone.

        • how is your salt and potassium intake ? and have you measured your blood ketones ?

          Instead of the high magnesium tablets you could try to eat some avocados with sea salt instead.

          I had severe leg twitching and cramps the first weeks i was on keto. I am now testing out a zero carb, no vegetables, and are not experiencing twitching and cramps anymore. My main problems are still mostly there though (hypothyroidism, adrenal fatigue, IBS, tiredness, depression).

    • Hi Asad, Are there ways to find out if you are low on these without blood testing such as the iodine test?

  6. So how does one go about figuring out just what is causing them to feel sick from a VLC diet? I did low carb 7 years ago, lost 40 lbs over 12 months and had no problems. Gained all the weight back over the past 2 years with a desk job and too many carbs. Started VLC mid-April and it seemed all was going as before. I track my macros, take the necessary supplements (like magnesium), upped my water intake and added more sodium. Then all of a sudden, last week I just crashed. I feel super sick, body aches like the flu, I have a migraine type headache that will not go away even with medication, I have nausea, some abdominal pain, feel thirsty despite water intake, have high anxiety/mood swings, and I am exhausted.
    I figured it was due to my diet, so after some research (here and elsewhere) decided to up my carbs. I have not taken in more than 75g though and I am really feeling horrible. Went to doc and vitals check out ok. Blood pressure is fine, heart sounds fine, etc. and no indications of some other health issue causing this, so pretty convinced I just hit a brick wall with the VLC.
    But I am confused with what I have read. It seems like it could be hypoglycemia, but the symptoms relate to too much cortisol as well. I understand they are related, but how can I pinpoint what is triggering me? Should I get tested for cortisol? Should I monitor my glucose? Or could I have messed up my thyroid and need to have it tested? Or all of the above??
    And once someone doing VLC has thrown their system out-of-wack, how long does it take to start feeling better? As I said, I increased my carbs 2 days ago but no relief yet. Some recommend doing a 200-300g intake of carbs, but I don’t want to do that if it will just trigger some other issue I might be having. Just trying to figure out how to better manage my diet and not feel like death warmed over. I think my age could have an effect on why the VLC is causing problems this time around. I was 39 last time, now I am 46. I figure hormone changes and different dietary needs are playing a role here. Any thoughts on this would be great 🙂

    • Dear Friend,

      I can relate with your problem. Like you I am also on a quest to health but somehow it is always easier to help others then yourself :P. When reading your post the first thing that popped up was this:
      – Are you measuring your blood ketone levels ?
      – And what about blood glucose ?

      If you have not done this prior then I highly advice you to do so. I use this measuring device which can both measure ketonines and glucose levels.
      https://www.abbottdiabetescare.ca/products/freestyle-precision-neo

      Also, how is your electrolyte intake ? Usually when one experiences your symptoms on a ketogenic diet its either too little elektrolytes (adrenal and thyroid problems increase cortisol, which decreases elektrolytes in the blood) or its is too little fat. Im in the same camp really. It is really hard to find a suitable range to be in but once you found your ratio then its a great find and support.

      Ask me any questions and I try to help.
      Cheers,

  7. I did Keto and I lost weight, but I looked and felt like a dead person and it just is not for me. I don’t think I could eat another scrap of meat or high fat food for a while. It upset my stomach and I just slept forever. My work performance suffered greatly too. Glad I’m not the only one who felt like a steaming bag of dog poo on Keto.

    • sounds to me you were going trough “keto flu” and were lacking severe magnesium,potassium, salt. I wouldn’t count keto out yet and rather find a suitable coach or mentor who could aid you in your journey.

  8. I have been eating LCHF for 2 years now. The first year was great and I went from 135 lbs down to 99 lbs. I was obviously too thin at this weight (I am 5ft 4ins ) so while on holiday last Christmas put on a few lbs. Now though, even though I am eating the same foods I have eaten for 2 years I am putting weight back on and am now 126 lbs. I also gave up smoking in Feb this year but still smoke e cigarettes so wondered if this had anything to do with it. I feel constantly tired and worn out whereas for the first year I had an abundance of energy. I rarely get a whole nights sleep and on lying down get jitters in my arms and legs and palpitations. I do not feel good anymore but cannot introduce any more carbs back into my diet as I know I will put weight on. The only place it seems to go is my belly. It is 12 years since my menopause so it is not that. I was reading your comments and wondered if my metabolism is out of sync and could it be hypothyroidism and what can I do about it. I cannot see any light at the end of my tunnel and feel that I am going to go into old age (I am 58) as a fattie. i have always looked after my body and prided myself on having a good figure with no fat, but all of that is un ravelling before my eyes. Help

    • Hi Shelly, You may want to look at this video

      I have a similar situation. I went paleo and began issues with dry eyes after a time. When I eat safe starches my eyes feel lubricated, but I put on weight. (I am very happy with my weight now I was too thin the first year as well). I feel like I must choose between the weight and my site!
      The shooting pain in my toes, jitters, twitching limbs and pins and needles in limbs that are not twisted bent or otherwise compromised as far as circulation and anxiety is all from vitamin B12 deficiency. I went through this 3 yrs ago. My doctor wouldn’t agree that I was deficient and finally he sent me to a sleep specialist for insomnia (life long). The specialist looked at the same numbers and told me I was B12 deficient. I went on a B complex for quite a while and changed my diet over completely to now grains. Improvement in everything was excellent including migraines, bloating etc……. and I slept! I recently purchased an entire book on B12 (I’m rather intense ha ha ha). The bottom line is, if you have a blood test you should be over 400 mg. Anything lower is a red flag, especially if you are supplementing. Most sites I trust suggest maintaining a level between 700 and 800. The book said maintain at 1000. My doctor had been telling me I was fine if I’m over 133.

      Eventually though, I began getting dizzy spells……….which lead to my looking into MTHFR. I stopped taking the B vitamins and the dizzy spells stopped, so to confirm, I went on line and ordered a DNA test………spit in a bottle……… postage paid………got the results very quickly. It turns out I have the MTHFR mutation (no surprise 60% of us do) During that time a neighbour called me for a ride home from the walk in clinic at our hospital since they wouldn’t let her walk home. She had gone because she was experiencing dizzy spells and they couldn’t help her. I told her about MTHFR and it turns out she has it too. She was able to switch the B vitamin she was taking to one without folic acid and she is fine now.
      So, you could be B12 deficient even though you are eating large amounts of meat for many reasons, but regular B supplements with folic acid may not be a good solution to the problem if you are. I make it a point to talk to pharmacists whenever I’m shopping. They have all been wonderful but none are familiar with any of the information I have been reading on B12 or MTHFR.

      • Hi Jackie thanks for your comments. My legs are still jittering , in fact they have been now for 2 whole days. I think a visit to the dotor may be in order or a change over from LCHF to Paleo as having read about this way of eating there seems to be more good carbs and fruit involved. I will let you know how I get on either way and thank you again for the video and advice

        • You’re welcome. Is the “jitters” that you describe Restless Leg syndrome?.
          I get RLS in a big way if I eat something with MSG. MSG http://blog.fooducate.com/nutrition-101/quick-food-facts/the-many-names-of-monosodium-glutamate.
          I have also noticed RLS when I take calcium. My doctor told me there should b no reason for this years ago, but I am taking a MOOC on physiology presently and they describe how calcium plays a major role in muscle activation, so not sure why he would say this. Could be I’m confused.
          If you are interested in finding out whether you have lots of B12 but it’s not getting to your cells. http://rawfoodsos.com/2014/12/05/my-un-vegetarianniversary-announcements-and-being-a-mthfr-mutant/.

        • Shelly your potassium is probably low which is causing your leg jitters and cramps. It’s near impossible to get enough from foods unless you eat high carb. Get some Nosalt and use liberally of get k lute supplement from your pharmacist. If your levels are less that 4.5 you need it, as most foods that contain it are high carb like potatoes bananas fruits etc. We need rda minimum 4700 mgs a day. Bet you’re not even half that on a diet like yours. Since I went on meq 8 potassium I no longer get freezing cold hands and feet no tingling or cramps.

          • Hi Neeters, yes I do believe you are right. Even though I have been taking quinine sulphate as prescribed by my doctor (crmps now gone) I still get tingling and jitters in my legs so I ate a banana for the first time in god knows how long and it calmed them within hours. I cover my food with low salt but that doesnt seem to do anything really. I think I shall just carry on perhaps eating a banana once a week or so and see how I get on. Thanks or the info all the same

            • Avocados are incredible sources of potassium without the blood sugar spike ? just a thought. Blessings on your journey.

              • Yes, but I’ve ruined that by blending them with honey and cinnamon to make an amazing pudding. When I think avocado now, I get cravings for pudding.

                • LOL Jackie! Just swap out the honey for some natural stevia, only need a teeny tiny bit and you will be good to go! 😉 I actually add cocoa powder to mine, I will have to try cinnamon.

                • I had to give up the cocoa powder in my avocado pudding because it was clearly standing in the way of my getting more than 2 1/2 hrs sleep……..sigh. I’m going to try the stevia. I have it, and I haven’t heard anything bad about it. I guess honey sounded natural and unprocessed. Thank you very much. I feel like I’m running out of things to eat.

          • My hands and feet have not been cold this last while because it’s been unbearably hot this summer and I’ve been active outside. The rest of the year I suffer cold hands and feet even if the rest of me is warm. I often have a banana for breakfast, so I’m going to see if maybe things are worse during periods when I switch to something else. Thank you for mentioning the relationship Neeters.

  9. A low-carb has benefitted our whole family. We all have much more regulated energy levels and have lost some weight. Most importantly, it has eliminated some major side effects from the psychiatric medications that our son takes. His cholesterol, triglycerides, and blood sugar are now completely normal and we have a goal to slowly reduce and eventually eliminate these meds. Since he has lost weight, he is able to participate in more physical activity In all the years that we worked with experts and sought various treatments, not once were we suggested to try a low-carb paleo diet. We started off strict in the first few months and now we are able to engage in occasional treats, but stick to hight carb paleo options as much as possible.

  10. Thank you so much for taking the time and energy to share this!! Suffered from PTSD for several years before diagnosed, with six months of therapy and my MD suggested then that I go vegan for cholesterol reasons. I did for 18 months, eating organic and clean with lots of carbs. Felt great emotionally and slept well!! Husband is type 2 Diabetic and more recently same doc told him to eat very low carb diet. I opted to switch to a pescatarian paleo type diet with very low carbs for myself and have had more anxiety and panic attacks in two weeks than I did in two years! I believed for years I have had adrenal fatigue and after ready your article and the link to the article on this subject it fits me perfectly! I have spent countless hours trying to find the right lifestyle diet solution to feel good and it is extremely stressful with all the contradiction out there. This was a blessing for me and I thank you both!!!!

    • Hi Phyllis,
      Have you tried “The Perfect Health Diet”? A scientist and his scientist wife developed it. It is free of grain, but incorporates a higher level of carbs. I haven’t purchased their book yet, but the website gives a great deal of information. http://perfecthealthdiet.com/

  11. Adrenal fatigue is a complex condition characterized by dysregulation of the adrenal output of cortisol which is regulated by the Circadian rhythm throughout a 24-hr day. To imply that high cortisol is the only effect of adrenal fatigue is incorrect. The reality is one can have too high or too low cortisol for any given point in the 24-hr cycle. And because cortisol is a glucocorticoid, one of whose main functions is to regulate blood sugar, especially in response to a flight or flight trigger, it is vital to pay attention to how carbohydrates in the diet affect blood sugar and cortisol’s ability to maintain homeostasis. In my clinical experience, in late stage adrenal dysfunction where a patient’s cortisol levels and adrenal reserve are chronically depleted, a temporarily lower carbohydrate diet is very helpful because it relieves the fatigued adrenals from having to produce cortisol.

    • very interesting post Leslie. Do you have some additional information or sources ?

      I am adrenal fatigued and have a low functioning thyroid (and most likely liver). Since some months I have done keto and it has been hard for me to spot the advantages.

      Since a few days im doing zero carb keto, meaning that I cut out all plants to avoid ” Salicylates “. I doubt this is doing me good but i will keep testing.

      I AM very interested in Histamines though. Adrenal dysfunction could well be a response of chronic histamine reactions that stimulate adrenal and cortisol from the adrenals.

  12. What if my workouts are fine and I am feeling good and strong, but my mood and energy outside of workouts are low/fluctuating? Would I benefit from upping my carbs?

  13. Unfortunately, I think good old fashioned trial and error, for most of us, is the only way to figure out how carbs affect one’s individual body. And, too, patience. When I was on VLC and felt like crap, I was terrified to add any carbs to my diet, even a little carrot, because I was in such a hurry to lose weight. As I wrote below, I *may* have damaged my thyroid because of it.

    Also — and REALLY unfortunately — age helps and trying to recall patterns about what works via weight loss and, importantly, how you feel. I think I finally figured out how bad I was feeling because I could compare it to other periods in my life when I felt good, or “normal.”

    Now, I am overweight, yes, but also too old to care so much. I am a middle-aged woman in her 40s; there’s only so much I can do! So, that has helped me be more patient and not afraid of carbs like I used to be – just wary of what kinds make me feel bad.

    I can also report that generally non-grain/wheat source of carbs (i.e. fruit or veggie) does not make me feel bad nor gain weight if #1. I eat it in moderation and #2. It’s not the first thing I eat or if I eat it on an empty stomach. That just sets me up for a sugar crash.

    p.s. rice with coconut oil sounds delicious!

  14. I’ll admit I am a bit wishy washy, but when reading the comments here, I am influenced to eat more carbs and less carbs at the same time (still haven’t read the actual article) because the postings are well written by intelligent people and important details are left out of the equation. I would love to see a place (forum I guess) where people can go and have all the information that is offered by others sorted out for them. I guess this would be a situation where you would have a list of question that would narrow things down for you and you could mess with the system a little. If you began by clicking yes to female and no to thyroid complications for instance, you would be able to read the responses that related to this. If you were to change your mind and decide that indicating female was limiting the responses you received, you could click ‘either’ for this and so on. This process could be very helpful for people who aren’t considering important factors, as well as for the easily swayed who have decided to disregard them.

  15. I am impressed that Chris has these articles and wonderful discussion forums. I thought that he would have a low carb focus and not devote so much attention to people having issues with this. He has an excellent site.

  16. Happy to report that low carbing did not ruin my health – although I was fearful for a while. In a nutshell: I ate an ultra-low carb diet (less than 40gms/day) for about thirteen years, and felt great the whole time. For the past few years, my fasting blood glucose was always slightly over 100, with a normal A1c. When my A1c came back elevated to 6.3 on my annual exam this year, I got concerned. NO DOCTOR was able to explain to me what had happened to my body. Were my beta cells asleep or dead? Were my peripheral cells now refusing to let in the glucose my body was making? Independently, I chose to try reversing the trend, adding back in some healthy carbs – mostly starches, no refined sugars., and supplementing with Gymnema. I stopped counting carbs, but I know I’m still eating relatively low. In four months, my A1c was back to 5.6, and my fasting blood glucose is always in the 80’s or low 90’s. More carbs . . . lower A1c. Go figure . . .

    • More carbs means mire insulin release therefore lower bg A1c. uts when you chronically overeat carbs and gain weight that your numbers go up and also if you Undereat carbs you get a type of “reactionary ” insulin resistance which is your body’s adapted state of carb starvation. Low carb and diets are all wrong. Anything in moderation is ok. Plain and simple. VLC stole 5 years of my life. I now eat everything i like and was able to get off thyroid meds and hormones and only supplement with a liquid mineral solution that is copper free and has selenium and 200 mcgs iodine plus Magnesium Chromium and a few other things in it and i take a B complex that is the methyl type by Thorne. I do eat some grains but not wheat. I am 56 and finally feeling better thanks to discovering the real source of my thyroid and chronic fatigue. ..not eating enough carbs and a sleep disorder. Cpap therapy within 6 months fixed almost everything. Adding in potatoes and orange juice daily has made me feel way better. And i eat grits with my eggs a couple times a week. I also eat a lot of beans and chick peas. Half my pkate is always greens or salad. Im still overweight as i gained 70 lbs at menopause from severe hormone imbalance. but im getting better.

  17. i had a short flirt with ketosis (6weeks) had a constant headache , i raised my sodium level this did nothing. so i came out of ketosis to around 50-60g carbs a day and that cured it. i feel great on this level of carbs, i hike every day, lift weights and run occasionally. i find low carbing an excellent tool for maintaining my weight loss. i’ve been around 130lbs for nearly 12 months and i find it easy to keep at a stable weight. we eat a Real Food diet (Primal with dairy) which is high in green leafy veggies and lean meats.

    • May I ask what carbs you eat? I hate weighing out my food. I tried it a couple of years ago and the ‘My fitness Pal’ ap I was using kept warning me that I was going too low carb. My nerves were shot at that time. I was heading for MS I was sure, so these warning were scaring the hell out of me………lol. I didn’t know what keto was, so when they said I was entering ketosis, they might just as well have said rigamortis. I have planned to try again many times, and I really should because I’m never sure what amounts I should be taking in. I’m the same weight and felt good on extremely low carbs, but my eyes became very dry and I keep finding eyelashes lately. I have not done well on a lot of safe starches…….tired or headache. Plantain was wonderful because you can make so many things with it, but I’m forever clearing my throat after eating it and Post Nasal Drip suggests allergy.

  18. I loved this post……finally had some concrete explanation why I was getting very depressed and exhausted on the low carb mildly keto diet after 3-4 weeks…..I was following roughly the wahls protocol, verging towards her paleo plus version…..I was eating some yams every week, but not every day…..

    After reading this article, I ate a whole cup of white rice with coconut oil guilt free last night, and today I feel a whole lot better…..I wish I could be one of those people who see god when they achieve “keto clarity” but clearly for me it is more like “keto hell”…..

    Thank you Laura, for explaining to us outliers that it is not our willpower but our genetics as always….

    • I think there are a lot of people who don’t respond well to a very low carb diet. I’m a little concerned with the fear of carbs that is developing. We see how the fear of fat worked for us! I too don’t function well on VLC and enjoy reading articles that back up the fact that it isn’t for everyone! Too many out there think it’s the ONLY way.

    • very low carb was terrible for me. weight gain, low thyroid, periods went, enormous amount of tummy fat gained. no energy to lift. raised to 70ish grams/day, no fruit but added squash and sweet potato. i am a new person. will never do VLC again. and this is with PCOS/IR taking metformin.

  19. How to get back to normal after low carb diet,now I can’t eat carbs, I’m feel bad after carbs please help me be a normal again.